Partnership for a Hispanic Diabetes Prevention Program

描述（由申请人提供）：与非西班牙裔白人相比，西班牙裔得不到充分的服务，更不可能利用健康教育活动。我们建议继续我们与社区合作伙伴在社区参与性研究（CBPR）项目中所做的工作，以减少农村地区西班牙裔人的糖尿病健康差异。我们的社区咨询委员会（CAB）与研究机构（FHCRC）密切合作，计划并实施了一个关于糖尿病的试点项目。在项目的早期，CAB资助了小型社区发起的研究项目，以确定适合本研究的最佳试点项目。它协助为试验项目和研究的CBPR方面拟订了一项评价计划。CAB一直在努力为这个干预研究阶段的项目做准备，在这个阶段，它计划进行一个更大的随机研究来测试干预措施。为此，本提案的具体目的是测试干预教育糖尿病患者和糖尿病前期患者关于糖尿病管理的有效性。在这个项目中，我们将继续与华盛顿州的下亚基马河谷开展CBPR项目。我们将与我们的CAB密切合作，测试一种干预措施，让患有糖尿病或糖尿病前期的西班牙裔患者接受家庭干预，与他们的家人和/或亲戚朋友一起管理他们的糖尿病。糖尿病信息将通过“家庭健康聚会”传递，在个人家中进行指导讨论。一名训练有素的健康教育工作者被邀请到家中进行四次关于糖尿病的指导讨论。讨论由在本奖助金的规划阶段制作和修订的几套挂图促进。研究人员给参与研究的个体一份关于糖尿病因素、饮食行为、身体活动、家族史和社会人口因素的基线问卷，然后随机选择立即接受干预，或者等待三个月后接受干预；这种延迟干预起到了控制的作用。干预的主要结果是随机分组后3个月A1c水平的变化。第二个结果是糖尿病知识的改变。将进行过程评估以确定干预的保真度。对CBPR过程的评估也将在整个试验期间的两点进行：干预中期和数据收集结束时。

DESCRIPTION (provided by applicant): Hispanics are underserved and less likely to take advantage of health education activities than their non-Hispanic White counterparts. We propose to continue the work we have done with community partners in a community-based participatory research (CBPR) project to reduce the diabetes health disparities experienced by Hispanics in a rural area. Our Community Advisory Board (CAB) has worked closely with the research institution (FHCRC) to plan and implement a pilot project on diabetes. Early in the project, the CAB funded small community-initiated research projects to identify the best pilot project that was feasible for this study. It has assisted in developing an evaluation plan, both for the pilot project, and for the CBPR aspect of the study. The CAB has worked diligently on preparing the project for this intervention research phase, where it plans to conduct a larger, randomized study to test the intervention. Toward that end, the specific aim of this proposal is to test the efficacy of an intervention to educate diabetics and pre-diabetics about the management of diabetes. In this project, we will continue our CBPR project with the Lower Yakima Valley of Washington. We will work closely with our CAB to test an intervention where Hispanic individuals with diabetes or pre-diabetes receive in-home intervention for managing their diabetes with their family members and/or relatives and friends. Diabetes information will be delivered through "home health parties," guided discussions in the individual's home. A trained promotora, or lay health educator, is invited to go into the home and present a four-session guided discussion on diabetes. The discussion is facilitated by sets of flip charts that were developed and revised in the planning phase of this grant. Individuals in the the study are given a baseline questionnaire on diabetes factors, eating behavior, physical activity, family history, and sociodemographic factors, then randomized to receive an immediate intervention, or are waitlisted to receive an intervention three months hence; this delayed intervention serves as control. The primary outcome of the intervention is changes in A1c levels three months after randomization. A secondary outcome is change in knowledge of diabetes. A process evaluation will be conducted to ascertain fidelity of the intervention. An evaluation of the CBPR process will also be conducted at two points throughout the trial: midway through intervention and at the end of data collection.